An Evolving Semi-Monthly Update on Community Mental Health in New York
April 2, 2007
State Budget Update
For the third year in a row, there’s talk of an on-time budget agreement between the Governor and the legislature. The proposals put forth by the Governor in his SFY 2007-2008 Executive Budget that would affect community behavioral health providers (i.e., year II of the CPI-indexed COLA, year III of the supported housing rate increase, etc.) are all but certain to be adopted in the final negotiations. What remains to be negotiated are additions and/or restorations to the budget proposed by both the Assembly and the Senate.
The Assembly and Senate Mental Hygiene Committees have agreed to add a total of $15 million to OMH, OASAS and OMRDD. We’ve highlighted some of the proposals below. Please note that these and other additions are subject to final approval from the leadership of the Assembly and Senate as well as from the Governor’s office.
STATE OFFICE OF MENTAL HEALTH -- $7.73 million
STATE OFFICE OF ALCOHOLISM & SUBSTANCE ABUSE -- $5.75 million
OMH Emergency Regulations Issued Regarding New Comprehensive Outpatient Programs (COPS)
The State Office of Mental Health has just posted emergency regulations to the NYS Register that can be viewed as the agency’s first step towards collapsing the distinction between COPS and non-COPS Article 31 treatment programs. In summary, the regulations will equalize the regional base Medicaid rates for providers within each of the three Article 31 treatment programs (clinics, continuing day treatment programs, and children’s day treatment programs), and then allow non-COPS programs (referred to in the regulations as “Level II” programs; existing COPS programs are referred to as “Level I”) to receive a COPS supplement of approximately 12% of the new base Medicaid rate. As a condition for receiving this supplement, the “Level II” programs will be required to fulfill five (5) conditions:
Please note that there will be no fiscal impact from these regulations for “Level I” providers. The bulk of the proposed funding increase – $2 million – was added to the OMH budget in the Spring of 2006 by the State Senate in an effort to address rate discrepancies between COPS and non-COPS providers.
These emergency regulations expire June 6, 2007. OMH “intends to adopt this emergency rule as a permanent rule and will publish a notice of proposed rule making in the State Register at some future date.”
You can access the most recent edition of the NYS Register here (http://www.dos.state.ny.us/info/register/2007/mar28/pdfs/rules.pdf). The relevant pages are 26-29.
DOHMH To Consolidate Family Support Services
DOHMH has just issued a concept paper (http://www.nyc.gov/html/doh/downloads/pdf/acco/2007/acco-concept-mh-20070226.pdf) for a “Coordinated Family Support Network” proposal that would effectively terminate all existing Family Support Services contracts in favor of five borough-based “Family Resource Centers” and one “Family Support Liaison Center”. Currently, there are approximately 26 different providers operating 32 programs.
For providers who hold homeless outreach contracts with DOHMH or DHS, this proposal should look very familiar – a borough-centric consolidation of numerous contracts operated by a broad range of providers.
DOHMH anticipates that the RFP for these contracts will be released in May 2007, with proposals due soon afterwards. DOHMH hopes to have selected contractors by July in order to begin operations in April 2008. Some number of existing contracts might be terminated this summer, while others will he phased out over the course of this year and next year.
DOHMH anticipates total funding for the five Family Resource Centers (FRC) to be $3.2 million; $250,000 is expected to be available for the Family Support Liaison Center (FSLC).
Coalition members with concerns about this proposal should contact Heather Mermel, Policy Associate at email@example.com or (212) 742-1600 ext. 109.
Its been an unusually busy election season, particularly if you live in Staten Island or in Central Brooklyn. The untimely loss of veteran Assembly Member John Lavelle, and the election of one former Council Member to Congress and another to the State Senate, led to a slew of special elections and no small measure of controversy. The items below will hopefully clarify matters…at least until the next election!
City Council swears in one new member, awaits another…
Vincent Ignizio (R) was sworn in on March 7th as the new City Council member from the 51st district in Staten Island, replacing Andrew Lanza who was elected last fall to the New York State Senate. Council Member Ignizio formerly served in the State Assembly.
Meanwhile, as we predicted in our last issue, complications arose for Matthieu Eugene which will result in a new special election being held for the 40th Council district in central Brooklyn. Though Mr. Eugene won the majority of the votes in an election held on February 20th, doubts arose about whether or not he lived in the district on the day he was elected. Another special election will take place on April 24th to allow residents of the district to once again choose a successor to Yvette Clarke, who was elected to Congress last fall.
Staten Island Elects Two New Members of State Assembly
Voters in Staten Island selected Matthew Titone (D) to fill the 61st Assembly District (previously held by the late John Lavelle, who died earlier this year) and Louis Tobacco (R) to fill the 62nd Assembly District (vacated by Vincent Ignizio, who was elected to the City Council in February.)
The Coalition congratulates Council Member Ignizio and Assembly Members Titone and Tobacco on their victories, and looks forward to working closely with them on issues of importance to the community behavioral health sector.
Governor Spitzer Signs Sex Offender Legislation
Governor Eliot Spitzer signed legislation earlier this month that would require sex offenders to undergo judicial review at the completion of their prison sentence to determine whether ongoing psychiatric treatment is warranted. If a determination is made that such treatment is in fact necessary, offenders would either be remanded to State psychiatric facilities (albeit in segregated units) or be mandated to receive treatment in outpatient settings.
The Coalition is particularly concerned about the latter scenario. While the legislation enhances funding to State psychiatric hospitals in order to accommodate and treat these individuals, there is presently no funding or training to assist community based mental health providers in outpatient settings. This stands in marked contrast to the “Kendra’s Law” legislation of 2000, which included State dollars for outpatient programs such as case management and ACT.
The Coalition, along with our colleagues at UJA-Federation of New York, has expressed this concern to the Governor (see letter), and we remain hopeful that necessary resources will be appropriated to community based mental health providers to ensure successful outcomes for the offenders and communities.
Report Claims New Citizenship Documentation Requirement Blocks Access to Medicaid for Thousands of U.S. Citizens
The new federal Medicaid citizenship documentation requirement has created additional barriers to receiving health care coverage for U.S. citizens and has played a significant role in the decline of Medicaid enrollment, particularly among low-income children, according to a new report issued by The Center on Budget and Policy Priorities. The new citizenship documentation requirement mandates current Medicaid beneficiaries and citizens applying for Medicaid to provide proof of U.S. citizenship, such as a birth certificate, passport or other form of identification.
The law was originally intended to prevent undocumented immigrants from receiving Medicaid coverage. However, it has predictably prevented tens of thousands of U.S. citizens from receiving necessary health care. Because of difficulties in documenting citizenship or identity. The new requirement has also led to an increase in administrative costs, longer waiting times for enrollment and a huge backlog of applications.
The Center's report examined Medicaid programs in Iowa, Kansas, Louisiana, New Hampshire, Virginia and Wisconsin. To read the full report, go to http://www.cbpp.org/2-2-07health.pdf.
Proposed Bill in Congress Will Increase Access to the Low Income Subsidy
Federal legislation was introduced on March 15, 2007 that would make it easier for low-income seniors to obtain the low income subsidy (LIS) for their prescription drug costs.
The bill H.R. 1536, introduced by Representative Lloyd Doggett (D-TX), would increase the asset eligibility for an individual from $11,500 to $27,500 and for couples from $23,000 to $55,000. The bill would also:
The bill currently has 161 cosponsors. If your local representative is not a sponsor please ask him/her to cosponsor this bill. You may look up your local representative by going to our website www.coalitionny.org and clicking on the 'Advocate for Mental Health' button on the left.
Center Staff Participate in NAMI’s Public Access TV Show
Alysia Pascaris, Marc Kutner and Pat Feinberg discussed the Center for Rehabilitation and Recovery’s promotion of systemic change efforts toward the integration of rehabilitation and recovery-enhancing services within New York City’s behavioral health care sector. In addition to a discussion of current training and technical assistance initiatives, Pat Feinberg had the opportunity to discuss her expanding role co-facilitating the Center’s borough-based Introduction to Benefits Management training series. Pat draws from her first-hand experience with numerous benefits and entitlements available to mental health consumers, particularly Social Security work incentives. The incorporation of Pat’s consumer perspective and systems knowledge has proved be a popular addition. Over 100 participants have taken part in sessions presented at the Postgraduate Center for Mental Health and the Howie T. Harp Peer Advocacy Center.
To watch this half hour interview and learn more about the Center, tune into NAMI’s Mental Health Update with Easy Klein on Time Warner Cable’s channel 56 on April 2nd at 8:30pm, or channel 57 on April 9th at 9:00am.
Coalition Testifies at Congressional Field Hearing on Mental Health and Substance Abuse Parity
On March 16th, The Coalition testified at Reps. Patrick Kennedy (D-R.I.) and Jim Ramstad’s (R-Minn.) Congressional Field Hearing on mental health and addiction parity. The hearing was hosted by Congressman Charles Rangel (D-NY). The Coalition applauded the Representatives for proposing and supporting legislation that would close the loopholes that allow insurance plans to offer limited coverage for mental health and substance abuse services, including the number of inpatient and outpatient visits, and impose increasingly higher co-pays, deductibles and out-of-pocket costs. The Coalition expressed the need for Congress to work together to create a federal parity bill that will build upon and strengthen state mental health parity laws and, importantly, not preempt state laws that provide greater consumer protections, benefits or methods of access to benefits. The full text of the testimony is available on our website.
The Coalition thanks Representatives Kennedy, Ramstad and Rangel for raising awareness and putting a public spotlight on the need and importance of mental health and substance abuse parity.
Coalition Delivers Budget Testimony Before City Council
Joined by twelve of its member agencies, the Coalition testified before the City Council’s Mental Health Committee last week about the need to restore funding to existing programs, enhance initiatives for seniors and children under five experiencing mental heath disorders, and develop a new suicide prevention initiative targeting vulnerable populations. The Committee, chaired by Council Member Oliver Koppell (D), was delighted by the large turnout of providers and advocates, and promised to fight to strengthen mental hygiene funding in the upcoming Fiscal 2008 budget negotiations with the Administration.
The Coalition would like to thank its membership for their strong turnout at the budget hearing, and for the eloquent and concise testimony regarding the needs of children, adults and seniors living with behavioral health disabilities. The Coalition also thanks its colleagues at UNH, UJA-Federation of New York and the Geriatric Mental Health Alliance for supporting our effort to enhance funding for the Council’s Geriatric Mental Health Services Initiative. We’re hopeful that our collective advocacy will result in the preservation of existing programs and the funding of new ones in the fiscal year beginning July 1, 2007.
Representative Stark Introduces Legislation That Would Create Mental Health Parity Under Medicare
House Ways and Means Health Subcommittee Chair Pete Stark (D-Calif) has introduced legislation (HR 1663) that would require mental health parity under Medicare. The bill would reduce the copayment for outpatient mental health benefits from 50% to 20%, which is the rate charged for most physical health services. It also would eliminate a 190-day limit on inpatient mental health treatment. The bill is expected to move separately from the mental health parity bill (HR 1424), co-sponsored by Reps. Patrick Kennedy (D-R.I.) and Jim Ramstad (R-Minn.).
Look for updates on this important bill in future editions of Briefs.
Free AOT Symposium for Community Providers
New York State Office of Mental Health, New York City Department of Health and Mental Hygiene and, New York City Health and Hospitals Corporation are sponsoring a full-day symposium on AOT for staff from continuing day treatment programs, outpatient clinics, residential facilities, IPRTs and PHPs.
Topics include: Dispelling the Myths of AOT, Defining Provider Roles and Responsibilities, Strategies for Engaging Individuals in a Recovery Process, The Latest Evaluation Findings on AOT and Recovery, and The Consumer Perspective on the AOT Experience.
Speakers include Aaron Vieira, LMSW, from the Coalition's Center for Rehabilitation and Recovery, OMH AOT Researchers, Borough AOT Team, and Consumers with AOT Experience.
This event is free and includes continental breakfast and lunch but registration is required. To register, contact Sonia Jackson at 212-868-6708 or firstname.lastname@example.org.
Around the Watercooler
City Council Names New Contracts Committee Chair
City Council Member Letitia James (WFP) from Brooklyn was selected by her colleagues earlier this month to chair the Council’s Committee on Contracts. The Coalition congratulates Council Member James on her appointment, and looks forward to working closely with her and her staff on a host of City procurement issues, especially those pertaining to the Division of Mental Hygiene.
Daines Confirmed by Senate for State Health Department
As predicted, the State Senate voted to confirm Dr. Richard Daines to be the new Commissioner for the State Department of Health. Prior to his appointment by Governor Spitzer, Dr. Daines was the President and Chief Executive Officer of St. Lukes-Roosevelt Hospital Center in Manhattan.
Hurwitz Named COO at Project Renewal
Mark Hurwitz, Deputy Commissioner for Adult Services at the City’s Department of Homeless Services, is set to become the new Chief Operating Officer for Project Renewal, a housing, health and behavioral health service provider with a full continuum of programs throughout New York City. Mark has been a good friend and an effective advocate during his tenure at DHS, and has worked tirelessly to find effective solutions for ending homelessness. We welcome him back to the non-profit sector and look forward to working with him in his new capacity. Project Renewal is a member agency of the Coalition.
Bruno named Director of Finance/Affiliate Corporations at CAMBA
Peter Bruno, a veteran budget official in the New York City Council’s Finance Division, will become the new Director of Finance/Affiliate Corporations at the Church Avenue Merchant’s Block Association (CAMBA), a community-based organization with a wide range of programs for homeless, low-income and immigrant New Yorkers. Over his 14 years at the City Council, Peter was instrumental in helping to ensure that community-based behavioral health programs had the funding they needed to operate effectively, and we thank him for his dedication and commitment to protecting vulnerable New Yorkers. CAMBA is a member agency of the Coalition.
New Position Created at NYC Department of Health and Mental Hygiene
The Division of Mental Hygiene in the NYC Department of Health and Mental Hygiene has created an innovative new position, a Family Advisor, to work with the Office of Child and Adolescent Services. This key position will bring a much valued parent/caregiver's voice to DOHMH in order to improve the services and supports offered to families and further promote family-driven care in NYC. The family advisor will be a parent/caregiver of a child with an emotional or behavioral disorder who has had experience with the children's mental health system. This person will add a family perspective to the work of the Division and the services offered as part of their local decision-making functions. For more information about the position, view the job posting on our job board: http://www.coalitionny.org/jobs/. To apply, please forward a resume and cover letter via e-mail to: email@example.com or via mail: Denise Arieli, MSW, New York City Department of Health and Mental Hygiene, Office of Child and Adolescent Services, 93 Worth Street-room 210D, New York, NY 10013.
Coalition to Bring Behavioral Healthcare Funding Concerns to Washington, DC
The Coalition will be going to Washington DC on Wednesday May 2nd to advocate for the protection of federal funding for behavioral healthcare and increased funding for HUD McKinney housing. We will be meeting with Senators Clinton and Schumer, as well as several Congress members who have key roles in the 110th Congress. We will be combining our efforts with members around the country of the National Council for Behavioral Healthcare during their Third Annual Hill Day.
With all but one member of New York City’s congressional delegation now in the majority party, the Coalition is eager to work with our delegation on issues of importance to our membership.
The Center’s Youth Initiative: Transition to Independence Process (TIP) Model Site Update
The six TIP (Transition to Independence) model sites (Staten Island Mental Health SafeTY.net, International Center for the Disabled Youth Employment Services Program, Institute for Community Living Linden House Child Community Residence, FEGS Yatzkan IPRT, Brooklyn Bureau of Community Service Adolescent Employment and Education Program, Coalition for Hispanic Family Services Bonding Links Family Based Treatment Program) came together for the second TIP Cross-Site Forum hosted by the Center for Rehabilitation and Recovery on March 12-14, 2007. TIP experts Drs. Hewitt “Rusty” Clark and Mason Haber provided sites with enhanced TIP implementation technical assistance. Site presentations indicated significant progress in integrating the TIP model, including: use of TIP transition domains to enhance assessment and articulation of client needs; revision of assessment and treatment plan tools to include emphasis on strengths, goal-setting, and family and other community involvement in treatment; fostering youth voice in programs by instituting leadership councils, community meetings, and entrepreneurial programs; outreach to community partners for employment and leisure activities.
Kaiser Family Foundation Releases Medicare and Medicaid Primers
Medicare provides benefits to 44 million people, including 7 million under 65 with disabilities, and Medicaid, the nations largest health coverage provider, covers 55 million lives. The new Medicare primer and updated Medicaid primer both provide an overview of the programs, who they serve, how the programs work, and how they are financed. The primers were prepared by Kaiser Family Foundation staff.
Coalition Management Training Series
There are still seats available for the last five sessions in the intensive training curriculum for new managers. The series is designed to help program staff learn crucial skills and tools necessary in order to succeed as managers.
The five remaining sessions are: Growing in Your Role as Manager (4/10), Financial Management (4/26), Financial Management cont. (5/14), Human Resources Issues (5/31) and Management Tools (6/8). The cost is $45 per session for members ($75 non-members). For more information and to register go to our website http://www.coalitionny.org/prof_learn_ctr/mti/index.html.
Coalition Job Boards
Coalition Members advertise staff positions for free on The Coalition’s Job Board! Here's a sample:
We also have a job board for psychiatrists only. APA members regularly look at this listing for potential hourly or per diem positions.